Hospitals' trauma and other charges should be fully paid before taxes are cut, hospital executives argued. / PBPost

On budget setting day, the board room at Wednesday’s Health Care District meeting was unusually crowded.

Hospital executives and lawyers from JFK Medical Center, Bethesda Memorial Hospital and St. Mary’s Medical Center were there in force, hoping to forestall plans for a property tax cut and restore previous years’ reimbursement cuts.

Doctors with the Palm Beach County Medical Society voiced concerns about a draft contract with the inspector general, on the grounds that it could allow auditors access to individual doctors’ offices and patients’ medical records.

And staff from the Palm Beach County Office of the Inspector General were there, too, to answer questions about the cost and details of putting the agency under its oversight.

In case you couldn’t make the meeting, here’s a sampling of what was said:

Dr. James Byrnes, Delray Beach family practitioner and president of the Palm Beach County Medical Society:

“As president of the Medical Society, I would ask that you exclude any doctors who serve clients of the Health Care District from the oversight of the inspector general, for a lot of reasons. Doctors are already under a lot of oversight. There are a lot of privacy issues we deal with every day with respect to medical records. Does the IG have access to patient records? I think it’s a huge, huge issue. The ability of the IG to walk into any doctor’s office and say, ‘Show me your records,’ I think that that will be a major disincentive for doctors to participate in the Health Care District. I think it’s an undue burden.”

David Carbone, CEO of St. Mary’s Medical Center:

“We would ask you to reflect on the fact that about a year ago, we as a trauma center had our direct funding to care for trauma patients reduced by 50 percent in 2010. That was $2.5 million at each hospital (St. Mary’s and Delray Medical Center).
You also eliminated retro payments (which allowed hospitals to be paid retroactively for an uninsured person’s hospital visit if they later qualified for Health Care District coverage.) This was a $1.7 million hit for St. Mary’s. We were also told that you would no longer fund trauma patients who were citizens of Palm Beach County if they were injured in Martin County. That was a several-hundred-thousand-dollar hit to St. Mary’s. We didn’t make any issue of the funding decreases last year because we knew times were tight. But if you are considering lowering the millage (property tax) rate, I hope that you would consider restoring retro pay first.”

Robert Hill, CEO of Bethesda Memorial Hospital:

“I’m sure you are all aware of what hospitals all around this country are facing with health care reform. Two of the reasons this Health Care District was funded was to provide trauma care, and to care for the indigent.
If all the draconian reductions come down from Medicare and Medicaid, and the retro payments are not reinstated at this level, it is fair to say that every hospital is looking at staffing reductions.
You pick up productivity in health care by having a nurse take care of seven, eight, nine patients instead of five. And I’m sure you would all love that. It is time to stop dumping the responsibility onto the health care worker, and for the public to step up to the responsibility for the laws of this country they have passed.”

The board tentatively passed a $260 million budget for 2011-2012 that would keep its property tax rate level at $1.1451 per assessed value, but wasn’t inclined to restore so-called “retro pay” given its likely $10 million hit to the district’s dwindling reserves.
Given an anticpiated drop in home values of about 2.5 percent next year, that would make district’s share of the property tax bill of the owner of a $250,000 home with a $50,000 homestead exemption $229.02.